亚急性脊髓联合变性的MRI表现

目的 :探讨亚急性脊髓联合变性(SCD)的MRI表现及特点,以提高SCD的诊断准确性。方法 :回顾性分析我院28例经临床及实验室检查证实的SCD,均行颈、胸段脊髓MRI平扫,其中9例行MRI增强扫描。结果:28例中血清维生素水平降低17例(60.7%),血清同型半胱氨酸水平升高11例(39.3%)。MRI上出现阳性特征16例(57.1%),其中颈髓阳性9例,胸髓阳性5例,颈胸髓同时阳性2例。增强扫描仅1例轻度强化。治疗后23个月复查,所有患者症状均不同程度减轻,MRI上异常信号范围缩小。结论:VB_(12)降低可引起SCD,当VB_(12)水平未明显下降时,血清同型半胱氨酸水平的升高有助于诊断该病。SCD的MRI表现有一定特点,可用于监测病情变化。     

脊髓亚急性联合变性的MRI诊断要点分析

目的分析脊髓亚急性联合变性(SCD)的MRI诊断要点。资料与方法回顾性分析15例临床确诊SCD的病人临床及MRI资料,分析其脊髓MRI表现特点,统计分析SCD病人受累脊髓节段数与血清VB12水平、发病时间的相关性。结果 15例SCD病人均于横断面影像上显示颈胸段脊髓对称性等或长T1、长T2信号,13例病变主要位于颈胸段水平脊髓后索,2例同时累及后索、侧索及前索。但于横断面T2WI上颈段与胸段脊髓异常信号形态各具特点。颈段脊髓受累时于横断面T2WI上呈脊髓内"倒V"形或"反兔耳"形的对称性高信号。胸段脊髓受累时于横断面T2WI上呈脊髓内"哑铃"形的对称性高信号。统计学分析显示15例SCD病人脊髓受累节段数与血清VB12水平呈负相关,而与病程长短无相关性。结论脊髓MR成像对于SCD脊髓疾病的诊断有重要价值。     

脊髓亚急性联合变性的MRI影像学特征

目的 评价MRI在脊髓亚急性联合变性(SCD)诊断中的重要价值. 资料与方法 收集经临床确诊的24例SCD患者的MRI资料,所有患者均于确诊前接受脊柱MRI检查,其中5例行增强检查,4例于治疗后复查.分析影像学特点. 结果 24例SCD中18例出现髓内异常信号,阳性率为75%.主要位于颈胸段脊髓后索(12例)或侧索并后索(5例),呈对称性等或稍长T1、长T2信号;1例同时累及后索、侧索、前索和部分灰质后角;脊髓无明显肿胀;增强后有(2/5)或无强化效应(3/5);治疗后4例病变范围均显示减小,甚至消失. 结论 SCD具有一定特征性的MRI影像表现,MRI在早期诊断及观察疗效上具有重要价值.     

继发椎管狭窄与脊髓亚急性联合变性MRI异常信号的相关性

目的：研究脊髓亚急性联合变性(SCD)的 MRI 表现特点,探讨继发椎管相对狭窄与 SCD 的 MR 异常信号的相关性。方法收集56例 SCD 患者的临床及 MRI 影像资料,分析 SCD 病例中椎间盘膨出/突出、黄韧带增厚、后纵韧带增厚或两者以上协同作用下的椎管相对狭窄与脊髓内病灶的表现特点。结果56例 SCD 患者中,MRI 检查脊髓表现有病灶的45例,均表现为典型的SCD 影像表现。继发椎管相对狭窄并脊髓信号异常者37例,继发椎管相对狭窄脊髓未见异常信号者2例,无继发椎管相对狭窄脊髓信号异常者8例,无继发椎管相对狭窄脊髓也未见异常信号者9例。比较采用χ2检验统计继发椎管相对狭窄与脊髓异常信号有显著性差异(P <0.05)。37例 SCD 有继发椎管相对狭窄中15例行物理治疗后较对照组病程缩短。结论继发椎管相对狭窄致脊髓微循环障碍是导致 SCD 脊髓病变 MRI 表现更显著或更易于显现的重要因素。     

脊髓亚急性联合变性的MRI诊断

脊髓亚急性联合变性 (ｓｕｂａｃｕｔｅｃｏｍｂｉｎｅｄｄｅｇｅｎｅｒａｔｉｏｎｏｆｔｈｅｓｐｉｎａｌｃｏｒｄ ,ＳＣＤ)是维生素Ｂ1 2 缺乏引起的营养障碍性脊髓病变 ,主要是脊髓后索、侧索和周围神经变性产生相应的临床表现。ＭＲＩ能显示脊髓后索及侧索的变性。本研究旨在通过对一组病例分析 ,探讨ＳＣＤ的ＭＲＩ表现特点 ,提高ＳＣＤ的诊治水平。1　材料和方法1.1　一般材料　 1996 0 4～ 2 0 0 0 11经临床、实验室和ＭＲＩ检查证实的 4例ＳＣＤ病例 ,均为男性 ,年龄 2 2～ 70岁 ,平均 43岁。患者均以下肢无力、行走不稳渐进性加重…     

脊髓亚急性联合变性的MRI诊断分析

目的 :探讨MRI对脊髓亚急性联合变性的诊断价值。方法 :回顾性分析12例经临床证实的脊髓亚急性联合变性患者的MRI表现。12例均行MRI平扫,2例加行增强扫描。结果:10例脊髓后索及侧索受累,双侧对称;后索单独受累1例;MRI未见异常1例。病变表现为带状或斑片状等T1长T2信号,STIR为高信号。2例行增强扫描无强化。结论:MRI能很好地显示脊髓亚急性联合变性的影像学特征,有助于脊髓亚急性联合变性的诊断。     

脊髓亚急性联合变性15例临床分析

目的　总结脊髓亚急性联合变性的临床特点 ,探讨该病的病因、电生理及其MRI表现。方法　对 15例脊髓亚急性联合变性的临床表现 ,实验室、电生理及MRI检查、常见病因、治疗方法进行了分析。结果　 15例均有后索、侧索及周围神经损害 ,以后索、侧索损害为主者 11例 (73 .3 3 % ) ,以周围神经损害为主者 4例 (2 6.67% ) ,伴精神症状者 3例 (2 0 % ) ,伴视力减退者 4例 (2 6.67% )。检测血清维生素B1 2 11例 ,其中降低 8例 (72 .73 % )、正常 3例 (2 7.2 7% )。MRI检查脊髓异常 2例 ,均为脊髓后索长条状对称性的等 (或 )长T1、长T2信号。结论　脊髓亚急性联合变性是由于维生素B1 2 缺乏以后索、侧索及周围神经损害为主的疾病 ,血清维生素B1 2 降低有助于脊髓亚急性联合变性的诊断 ,但不是一个绝对可靠的指标。脊髓MRI检查对本病具有客观诊断价值。     

脊髓亚急性联合变性24例临床分析

目的 探讨脊髓亚急性联合变性（SCD）的临床特点及转归。方法本组24例患者的临床资料。结果16．7％（4／24）患者有贫血,37．5％（9／24）患者血清ViB12水平降低。50％（10／20）脊髓MRI检查发现,患者脊髓后索存在异常改变,58.3％（14／24）肌电图有异常,应用ViB12后所有患者均有不同程度的好转。结论SCD由ViB12缺乏引起,结合临床特点,辅助检查,试验性ViB12治疗有效,可提高确诊率。     

MRI诊断脊髓亚急性联合变性2例

<正>脊髓亚急性联合变性(subacute combined degeneration of the spinal cord,SCD)是维生素B12缺乏引起的神经系统变性疾病,临床较少见,早期诊断、及时治疗是改善本病预后的关键。MRI检查能清晰显示脊髓病变部位、受累范围,具有一定的特异性,为SCD的早期诊断及预后随访提供了良好的检查手段。现报道我院经临床确诊的2例SCD的脊髓MRI表现,以提高对本病的认识。     

MRI联合血红蛋白、血清维生素B12对脊髓亚急性联合变性的诊断价值

目的：探讨MRI联合血红蛋白及血清维生素B₁₂检查对脊髓亚急性联合变性(SCD)的诊断价值。方法：回顾性分析41例经临床诊断为SCD患者的临床及MRI资料,根据脊髓MRI结果分为A组(MRI阳性)、B组(MRI阴性);统计分析2组血红蛋白水平、血清维生素B₁₂含量及脊髓内MRI异常信号的差异。结果：A组12例,其中8例累及脊髓后索和/或侧索呈典型表现,血红蛋白均值为(109.4±15.2)g/L,血清维生素B₁₂均值为(141.0±39.2)ng/L;4例累及脊髓灰质及后索、侧索呈非典型表现,血红蛋白均值为(115.1±17.5)g/L,血清维生素B₁₂均值为(182.8±101.9)ng/L;12例异常信号范围均超过3个椎体,脊髓形态无明显肿胀。B组29例,血红蛋白均值为(134.7±16.2)g/L,血清维生素B₁₂均值为(199.2±31.4)ng/L。2组血红蛋白水平差异有统计学意义(P<0.05),血清维生素B₁₂水平差异无统计学意义(P&...     

MRI of spinal cord and brain lesions in subacute combined degeneration

Subacute combined degeneration is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and even more rarely of the pyramidal and spinocerebellar tracts and cerebellum. We present the initial and follow-up MRI appearances in a patient with subacute combined degeneration of the spinal cord, brain stem and cerebellum, due to vitamin B₁₂ deficiency. The lesions in these structures were demonstrated clearly as pathologically high-signal areas on T2-weighted images. These lesions, except those of the brain stem and cerebellum, disappeared 4 months after therapy. MRI 14 months after the patient's discharge on vitamin B₁₂ therapy showed the same picture. Received: 24 July 1997 Accepted: 20 November 1997     

Subacute combined degeneration of the spinal cord with involvement of the anterior columns: a new MRI finding

We present a case of vitamin B12 deficiency and subacute combined degeneration in a patient with a gastrectomy. MRI showed high-signal lesions on T2-weighted images in both the posterior and anterior columns, associated with minor thoracic spinal cord expansion. The patient was treated with B12 supplements and clinical improvement was associated with reduction of the size of the lesions on MRI. Received: 11 August 1998/Accepted: 13 July 1999     

A case of subacute combined degeneration: MRI findings

The specific spinal cord lesion caused by vitamin B12 deficiency is known as subacute combined degeneration (SCD). Neuropathological studies of SCD show lesions mainly in the posterior and lateral columns, involving the cortico-spinal and spino-cerebellar tracts. We report a case of SCD in a 19-year-old man who presented with 4 weeks history of gradually progressing tingling in both hands. MRI of the cervical spine demonstrated symmetrical areas of T2 signal abnormality involving the dorsal columns of the cervical cord from the C2 through C5 levels associated with spinal cord expansion. He was treated with vitamin B12 supplements and experienced gradual improvement in his clinical symptoms. Repeat MRI of the cervical spine after 2 months revealed slight decrease in the area of abnormal signal. Received: 6 August 1997 Accepted: 18 August 1997     

核磁共振成像在脊髓损伤中的应用

核磁共振成像（ＭＲＩ）在脊髓损伤的诊台中具有重要的意义：ＭＲＩ上表现为出血者较单纯水肿者的病情重,预后差,且均与病灶的大小有关;有脊髓压迫者的病情重,预后差;ＭＲＩ对指导创伤性脊髓空洞症的治疗也有重要的价值。     

MRI in subacute combined degeneration

We describe a patient with clear lesions in the spinal cord on MRI due to subacute combined degeneration. T2-weighted images clearly showed abnormal high signals in the posterior columns, which disappeared on recovery from the disease.     

亚急性联合变性患者认知功能障碍的初步研究

目的:探讨亚急性联合变性(SCD)患者认知功能障碍的特点及其与血浆高同型半胱氨酸(Hcy)水平、运动功能受损程度和抑郁障碍的相关性。方法:选择SCD 32例作为观察组,脊髓病变32例作为对照组,分别应用简易精神状态检查量表(MMSE)和蒙特利尔认知状态评定量表(MoCA)对其认知功能进行测试,比较两组评分;同时对SCD患者进行血浆Hcy水平、运动功能评定量表(FDS)及汉密尔顿抑郁量表(HAMD)评分测定。结果:两组MMSE评分比较,差异不显著(P>0.05);MoCA总体评分及视空间与执行功能、注意力、延迟记忆条目分值比较,均差异非常显著(P<0.01)。SCD患者MoCA评分与FDS评分及HAMD评分呈正相关,与血浆Hcy水平呈负相关。结论:MoCA较MMSE更易识别SCD患者的认知功能障碍,SCD患者认知功能障碍以执行功能、注意力及延迟记忆最为突出,其障碍程度与其血浆Hcy水平、运动功能受损程度及抑郁程度密切相关。     

MRI characterization of diffusion coefficients in a rat spinal cord injury model

Apparent diffusion coefficients (ADC) were measured in a rat spinal cord weight-drop injury model. After sacrifice, the spinal cords were fixed in situ and excised for MR imaging and ADC measurement. Diffusion is anisotropic in normal gray and white matter. There were significant decreases in ADCs measured along the longitudinal axis of the injured cord and increases in ADCs measured transverse to the cord. Injured segments demonstrated reductions in diffusion anisotropy in the white matter. Diffusion was completely isotropic at the epicenter of the weight-drop injury. Significant decreases in longitudinal ADC and increases in transverse ADC were observed in portions of the cord which appeared normal on conventional spin-echo and calculated T₂ images. Thus ADC measurement may complement routine imaging for evaluation of spinal cord injury.     

Functional MRI of the thoracic spinal cord during vibration sensation

Purpose:

To demonstrate that it is possible to acquire accurate functional magnetic resonance images from thoracic spinal cord neurons.

Materials and Methods:

The lower thoracic spinal dermatomes (T7–T11) on the right side of the body were mechanically stimulated by vibration for 15 participants. Neuronal responses to vibration sensation were measured in the thoracic spinal cord using a HASTE sequence on a 3 Tesla MRI system.

Results:

Signal increases were observed in the corresponding lower thoracic spinal cord segments ipsilateral to the side of stimulation in the dorsal aspect of the spinal cord.

Conclusion:

This is the first study to provide proof of principle that functional imaging of the entire thoracic spinal cord is possible, by detecting neuronal activity in the thoracic spinal cord during sensory stimulation using spinal fMRI. J. Magn. Reson. Imaging 2013;37:981–985. © 2012 Wiley Periodicals, Inc.